Kornimate/medical-research-clean huggingface dataset:
the application of analgesia nociception index as an objective labor pain assessment during epidural analgesia

Conditions: Labor Pain

Summary: epidural analgesia is considered an effective and safe method for obstetric pain control. currently, self-assessment pain scales remain to be the gold standard in labor pain evaluation after the administration of epidural analgesia. however, individual patient susceptibility to pain perception makes difficulties for the clinicians to assess the effectiveness of painless labor precisely. the aim of this study is to evaluate the validity of ani in obstetric pain monitoring during epidural analgesia.

epidural analgesia is considered an effective and safe method for obstetric pain control. currently, self-assessment pain scales remain to be the gold standard in labor pain evaluation after the administration of epidural analgesia. however, individual patient susceptibility to pain perception makes difficulties for the clinicians to assess the effectiveness of painless labor precisely. without a convincing objective tool for obstetric pain evaluation during epidural analgesia, the clinicians are hard to adjust adequate epidural drug dosage. establishing an objective pain index would help the clinicians to have a better pain management during labor. in 2012, m. le guen et al. demonstrated a linear relationship between visual analogical pain scores(vas) and analgesia nociception index (ani) values during labor. their efforts started the application of ani in obstetric pain monitoring. however, the reliability of ani in obstetric pain monitoring under epidural analgesia have not yet been verified. the aim of this study is to evaluate the validity of ani in obstetric pain monitoring during epidural analgesia.

Eligibility criteria:
inclusion criteria: * parturients with gestational age more than 35 weeks * ages between 20 to 50 * received epidural analgesia * american society of anesthesiologists classification i or ii. exclusion criteria: * 1. who refused to join the study * 2. with a history of arrhythmia * 3. american society of anesthesiologists (asa)classification \>= iii * 4. with a history of cardiovascular, pulmonary, endocrine, neurologic or psychiatric disease * 5.using medications that affecting heart rate * 6. cannot understand the explanation of the study * 7. high-risk gestation * 8. known fetal anomaly

Keywords: analgesia nociception index painless labor epidural analgesia
injury prevention among conscripts

Conditions: Back Problems and Other Musculoskeletal Injuries

Summary: the purpose of this clinical trial is to study the effect of neuromuscular training program and regular safety counselling on the risk of musculoskeletal injuries in adolescent conscripts. 800 voluntary participants are recruited from the four army companies in western finland during the years 2007 and 2008.


Eligibility criteria:
inclusion criteria: * healthy conscripts who gave informed consent for participation exclusion criteria: * disease or injury preventing physical training

Keywords: low back pain physical fitness injury prevention conscripts
platelet leukocyte aggregates in acute cardiac syndrome vs healthy volunteers

Conditions: Myocardial Infarction

Summary: this project aims to refine previous studies including the investigators work recently published in august 2012 journal thrombosis and thrombolysis. that study showed a relationship between the level of platelet leukocyte aggregates in patients with acute coronary syndrome. the investigators intend to compare the characteristics of platelets, monocytes and neutrophil data of volume, scatter and conductivity obtained from routine blood count level with flow cytometry results defining platelet leukocyte aggregates. the investigators hypothesize that there will be a direct correlation between elevated platelet-leukocyte aggregates and biophysical data from the blood count.

the goal is to investigate whether there is a simple and inexpensive method to test the level of platelet leukocyte aggregates through the blood count test. the parameters which are obtained routinely for white blood cell counts include: capacity - electrical conductivity (conductivity) - dispersion (scatter), and volume. though these values are not reported routinely, they can be accessed for each blood count. the premise is that through blood counts (no need for specialized flow cytometry) and through the parameters mentioned a conclusion can be reached about platelet leukocyte aggregates. this will then aid in prognosis about the risk of an acute event for every patient with ischemic heart disease who comes to the emergency room.

Eligibility criteria:
inclusion criteria:signed consent form, over 18 years of age, diagnosis of stemi or non-stemi as per following: * acute st elevation myocardial infarction (stemi) was diagnosed in patients with high level of troponin i (\>0.4 ng/ml), st segment elevation in at least two contiguous leads of the ecg (or new lbbb) and/or ischemic chest pain. * acute non st elevation myocardial infarction (non stemi) was diagnosed if level of troponin i was \> 0.4 ng/ml, patient had ischemic chest pain or st-t depression and/or t-wave inversion on ecg. exclusion criteria:inability to sign consent form, under 18, participation in other research projects within previous 6 months. -

Keywords: myocardial infarction flow cytometry blood cell count platelet activation
endoscopic resection for small rectal neuroendocrine tumors

Conditions: Rectal Neuroendocrine Tumor

Summary: in previous single center study, both modified cap-assisted endoscopic mucosal resection (memr-c) and endoscopic submucosal dissection (esd) were reported to be effective for the treatment of small rectal neuroendocrine tumors (nets) and memr-c was inferior to esd for the treatment of small rectal nets (≤10 mm), as it has shorter operation times and lower hospitalization costs. however, a multicenter randomized controlled trial is needed to prove the universality and generality of these findings.

investigators aimed to conduct a muticenter randomized controlled trial to compare memr-c with esd for the treatment of small rectal neuroendocrine tumors (nets) in six tertiary hospitals in china.

Eligibility criteria:
inclusion criteria: 1. age from 18 to 75 years; 2. with a high suspicion or evidence of rectal net assessed using eus or colonoscopy; 3. with tumor size ≤10 mm assessed by colonoscopy; 4. plan to receive memr-c or esd treatment and provide written informed consent; exclusion criteria: 1. unable to tolerate esd or memr-c as assessed by the research team of each center; 2. complicated with serious diseases such as malignant tumor, which may lead to shorter life expectancy, the research team considers that it is not suitable for inclusion in the study after comprehensive evaluation; 3. rectal net with lymph node metastasis or distant metastasis; 4. received resection of rectal neuroendocrine tumor by other surgical procedures; 5. multiple rectal neuroendocrine tumors; 6. vulnerable groups such as pregnant women or patients with mental disorders; 7. poor compliance, unable to cooperate with treatment.
effectiveness of repetitive transcranial magnetic stimulation in depressed patients

Conditions: Major Depression

Summary: the purpose of this study is to evaluate clinical efficacy (affective and cognitive) in patients with moderate depression between tms over the left dorsolateral prefrontal cortex (dlpfc) with simulated tms, as well as clinical response when 5 sessions / week are applied vs. 2 sessions / week. all patients will receive 15 tms sessions as initial treatment (active or sham) and respondents will participate in an tms follow-up on the left dlpfc for three months.

this is a randomized, double-blinded, placebo-controlled, parallel group clinical trial to evaluate the efficacy of two transcranial magnetic stimulation (tms) protocols in patients with major depressive disorder (mdd). 70 ambulatory patients with a mdd diagnosis from the clinic at the department of psychiatry and mental health at the universidad nacional autónoma de méxico (unam) will be included. all patients will complete a total of 15 sessions of treatment in any of four groups: a group of patients will be randomly assigned to receive either 5 active tms sessions or 2 sessions per week. sham controls will also be randomly assigned to receive either 5 tms sessions or 2 sessions per week. afterwards, all participants will receive 2 sessions per month for a 3 month period. depressive and anxiety symptoms will be evaluated at baseline, and every 5 tms sessions during the acute treatment phase, and once at the end of a 3-month follow up. in addition, neuropsychological evaluations will be applied at baseline and at the end of the 15 session's treatment. sessions will be applied with a mag pro x 100 transcranial magnetic stimulator. motor threshold will be set. sessions will be applied over the left dlpfc at 5 hz, 30 trains, 100%. categorical variables will be described by percentages and frequencies. continuous variables will be described by means and standard deviations. treatment groups will be compared using student's t test. cognitive, anxiety and depressive symptom scale scores between treatment groups will be compared using repeated measures anova.

Eligibility criteria:
inclusion criteria: * clinical diagnosis of major depressive disorder * having a greater or equal score to 18 points in the ham-d scale at the moment of the initial evaluation * treatment free patients exclusion criteria: * epilepsy or seizure risk record * carry metallic objects in the head (such as arterial clips, plates, screws), eye or brain

Keywords: stimulation magnetic transcranial, major depression, cognitive impairment
effects of optimized blinking training on visual function and tear film parameters in individuals with cvs

Conditions: Computer Vision Syndrome

Summary: "computer vision syndrome (cvs), refers to a range of eye and vision issues caused by extended use of computers, tablets, e-readers, and smartphones. computer users experience visual symptoms, such as eyestrain, headaches, eye discomfort, dry eyes, double vision, and blurred vision, especially after long periods of looking at screens, whether up close or at a distance.

individuals will be randomly assigned to either an experimental group (group a) receiving obt with routine rehabilitation cvs management 20-20-20 rule, blue light-blocking glasses, and polyvinyl alcohol eye drops or a control group (group b) receiving only routine rehabilitation, including the 20-20-20 rule, blue light-blocking glasses, and polyvinyl alcohol eye drops. obt consisted of structured blinking exercises performed thrice daily for three months. objective outcomes, including tear film parameters and visual function using subjective computer vision syndrome questionnaire (cvs-q) shall be evaluated. the collected data will be analysed by using spss."

Eligibility criteria:
inclusion criteria: * individuals aged 18-40 years who work on computers or digital devices for at least 3 to 6 hours daily. * both male and female. * individuals who could undergo a complete ocular examination. * presence of symptoms consistent with digital eye strain. * presented with eye complaints such as eye fatigue, burning, irritation, redness, and blurred vision due to long-term computer or digital screen use. * symptoms worsened during exposure to digital screen light. exclusion criteria: * use of medications that might influence tear production or ocular surface status (e.g., antihistamines, antidepressants). * diagnosed neurological or systemic conditions that impact vision or blink patterns (e.g., parkinson's disease, multiple sclerosis). * individual's with a history of ocular surface diseases such as conjunctivitis or keratitis. * history of any psychiatric diagnosis."
safety and efficacy of zemplar capsule in reducing serum ipth levels in chronic kidney disease subjects (daily dosing)

Conditions: Renal Insufficiency, Chronic

Summary: the objective of this study is to determine whether paricalcitol is safe and effective compared to placebo in reducing elevated serum pth levels in patients with chronic kidney disease.


Eligibility criteria:
inclusion criteria: * under care of physician at least 2 months (for ckd) * not on active vitamin d therapy for at least 4 weeks prior * if female: * not of childbearing potential, or, * practicing birth control * not breastfeeding * if taking phosphate binders, on a stable regimen at least 4 weeks prior * for entry into pretreatment phase: * ipth at least 120 pg/ml * gfr of 15-60 ml/min and no dialysis expected for at least 6 months * for entry into treatment phase: * average of 2 consecutive ipth values of at least 150 pg/ml, taken at least 1 day apart (all values not less than 120 pg/ml_ * 2 consecutive corrected serum calcium levels between 8.0-10.0 mg/dl * 2 consecutive serum phosphorus levels of not more than 5.2 mg/ml exclusion criteria: * history of allergic reaction or sensitivity to similar drugs * acute renal failure within 12 weeks of study * chronic gastrointestinal disease * spot urine result demonstrating a urine-calcium-to-urine creatinine ratio of greater than 0,2, or a history of renal stones * taken aluminum-containing phosphate binders within last 12 weeks, or requires such medication for more than 3 weeks during study * current malignancy, or clinically significant liver disease * active granulomatous disease (tb, sarcoidosis, etc.) * history of drug or alcohol abuse within 6 months prior * evidence of poor compliance with diet or medication * received any investigational drug or participated in any device trial within 30 days prior * taking maintenance calcitonin, bisphosphonates, or drugs that may affect calcium or bone metabolism (other than females on stable estrogen and/or progestin therapy) * on glucocorticoids for a period of more than 14 days within the last 6 months * hiv positive
non-opioid anesthesia in bariatric surgery

Conditions: Severe Obesity

Summary: opioid-free anesthesia is a new approach to anesthesia, described and used for many years. if it represents many advantages by reducing the side effects of morphine, its precise place in current practice and in terms of postoperative rehabilitation remains to be determined. studies are not yet numerous enough to affirm a real benefit. obese patients are potentially able to benefit from the reduction in the use of morphine during surgery, in terms of quality of postoperative analgesia, side effects (respiratory depression, ileus, somnolence) and early rehabilitation.


Eligibility criteria:
inclusion criteria: * major subject (≥ 18 years old), * who have undergone bariatric surgery at the hus between january 01, 2017 and december 31, 2019 * subject who has not expressed his or her opposition, after information, to the reuse of his or her data for the purpose of this research exclusion criteria: * subject who has expressed his/her opposition to participate in the study * subjects under guardianship, curatorship or legal protection, pregnant women

Keywords: bariatric surgery opioid-free anesthesia non-opioid anesthesia severe obesity
epidemiology of sleep disordered breathing in children

Conditions: Lung Diseases; Sleep Apnea Syndromes

Summary: to collect fundamental data regarding the distribution of measures of sleep disordered breathing (sdb) in a pediatric population, prevalence of clinically significant sdb in children, risk factors, and associated co-morbidity.

background: developing strategies for recognizing and treating children with sleep disordered breathing (sdb) was not possible in the absence of essential epidemiological data that addressed the distribution of measures of sdb in pediatric populations. the potential public health importance of this was underscored by preliminary data that suggested that risk of sdb was increased in susceptible populations, in particular in african americans and in children born prematurely. design narrative: the design was that of a cohort study with a nested case control arm. sleep disordered breathing was evaluated in 850 children with in-home state-of-the art respiratory monitoring techniques. a number of risk factors were evaluated: sociodemographic characteristics; anthropometry; upper and lower airway size and function (questionnaire, spirometry, and reflectometry); perinatal exposures (from neonatal records); family history; and home environment (passive smoking; sleep patterns, maternal-child stress indices). behavior, cognitive skills, attention, and health-related quality of life were assessed with standardized instruments to assess co-morbidities (potential sdb outcomes). analysis of the longitudinal data provided cognitive-developmental trajectories that were evaluated in relationship to sdb. the case-control arm confirmed and extended the findings of the in-home assessments with comprehensive laboratory polysomnography, cephalometry, and objective measures of sleepiness (multiple sleep latency tests) in three groups of children: definite sdb by home assessment; equivocal sdb; and no sdb. collection of comprehensive polysomnographic data helped to identify which measures best discriminated symptomatic (e.g., snoring, sleepy) from asymptomatic children. the study completion date listed in this record was obtained from the "end date" entered in the protocol registration and results system (prs) record.

Eligibility criteria:
no eligibility criteria
hydroxycobalamin and rural emergency medical services cyanide exposure patients: a cost analysis

Conditions: Cyanide Poisoning

Summary: the costs to a rural emergency medical services (ems) system of a change from a traditional cyanide antidote kit to a kit containing hydroxocobalamin alone are currently unknown. the purpose of this study is to use current ems data to calculate the costs to a rural ems system associated with the adoption of a hydroxocobalamin protocol for the treatment of suspected cyanide exposure.


Eligibility criteria:
inclusion criteria: * included in maine ems database * house fire victim * poisoning exclusion criteria: * no potential cyanide exposure * incomplete data available

Keywords: pharmacoeconomics cost effectiveness cyanide fire emergency medical services smoke inhalation
aliskiren and muscle sympathetic nerve activity

Conditions: Chronic Kidney Disease; Hypertension; Muscle Sympathetic Nerve Activity

Summary: the central hypothesis of this project is that aliskiren causes a substantial decrease in msna in hypertensive patients with ckd.

cardiovascular (cv) morbidity and mortality are frequently occurring problems in chronic kidney disease (ckd) patients. apart from the so called traditional risk factors, also risk factors more or less specific to ckd contribute in the pathogenesis of these problems. there is strong evidence that the sympathetic hyperactivity, which often characterizes ckd, is one such factor. previously, we have shown that angiotensin converting enzyme inhibitors (acei) and angiotensin ii receptor blockers (arb) reduce but not normalize this sympathetic hyperactivity. we re-analysed the cohort of patients who were investigated in the past and subsequently treated according to present guidelines. the results show that, despite of treatment, the unfavourable relation between sympathetic hyperactivity and clinical outcome still exits. this might mean that treatment is insufficient. in present study, we want to study the effect of aliskiren 300mg on sympathetic nerve activity.

Eligibility criteria:
inclusion criteria: * patients with stable chronic kidney disease and hypertension: i.e. using antihypertensive drugs and/or blood pressure \> 145/90 mmhg when off medication. * patients on ace inhibitor or arb exclusion criteria: * patients with diabetes mellitus * patients on renal replacement therapy * pregnant patients using of antihypertensive which cannot be stopped * patients on immunosuppressive therapy and active nephrotic syndrome

Keywords: renin inhibitor patients ace inhibitor or arb chronic kidney disease hypertension
effects of physical exercise on blood glucose and pain from the musculoskeletal system in patients with type 2 diabetes

Conditions: Type 2 Diabetes Mellitus

Summary: the aim of this study is to investigate the effects og physical exercise on bloodglucose and pain from the musculoskeletal system in patients with type 2 diabetes. the patients will be recruited to 12 weeks of exercise twice weekly. the outomes are long term bloodglucose (hba1c) and pain reported in questionaires. in data analyses the patients will be stratified to patients with a high or a low degree of complications related to diabetes.

design: uncontrolled intervention study patients: type 2 diabetes from nordsjællands hospital, denmark inclusion critera: adults, type 2 diabetes, not participating in an ungoing exercise program, able to conduct exercise training exclusion criteria: unable to understand danish, psychiatric disorder, dementia intervention: two times one hour exercise training for 12 week. the training will be combined aerobic and resistance training supervised by physiotherapists outcome: bloodglucose, pain (questionaire) sample size: 80 participants

Eligibility criteria:
inclusion criteria: * clinical diagnosis of type 2 diabetes * must be able to perform physical exercise exclusion criteria: * participation in structured exercise program within the past three months * dementia * unable to understand danish language

Keywords: exercise, physical
management of direct oral anti-coagulants (doacs) for gastrointestinal endoscopy procedures

Conditions: Anticoagulant Disorders

Summary: the use of direct oral anti-coagulants (doacs) is expanding, but their proper management in patients undergoing endoscopic procedures is still not completely clear. current european guidelines are based on weak data. this observational study aims to evaluate the peri-endoscopic management of doacs in clinical practice and the incidence of adverse events.

this observational study is aimed at evaluating the peri-endoscopic management of doacs in patients undergoing elective gastrointestinal endoscopy procedures and the adverse events (bleeding and thromboembolic events) associated with. all consecutive patients undergoing elective procedures and providing informed consent will be included. primary end-point: incidence of major bleeding events according to international society thrombosis haemostasis (isth) criteria and clinically relevant non-major bleeding events occuring during the endoscopy procedures or within 30 days, according to international society thrombosis haemostasis (isth) criteria in patients in which doacs have been managed according to european society of gastrointestinal endoscopy (esge) guidelines secondary end points: * incidence of major bleeding and clinically relent non-major events in the overall patient population * incidence of bleeding events in the overall patient population * incidence of thromboembolic events in the overall patient population and in patients in which doacs have been managed according to esge guidelines * compliance with esge guidelines

Eligibility criteria:
inclusion criteria: * patients (both inpatients and outpatients) undergoing endoscopic procedures during doacs therapy exclusion criteria: * inform consent not possible to obtain * not willing patient